Safety incidents and obstructive sleep apnoea in railway workers.

Background: Current evidence is lacking to justify more stringent screening for obstructive sleep apnoea (OSA) in the rail industry. Population-based studies indicate a complex association between body mass index, age, apnoea-hypopnoea index and vehicle crash risk.

Aims: To study the association between OSA severity and the occurrence of safety incidents in safety-critical rail workers with a confirmed diagnosis of OSA, and to identify if OSA treatment is associated with the occurrence of fewer safety incidents.

Comparison of Urine and Oral Fluid for Workplace Drug Testing.

Aims: To determine the relative detection rates of urine versus oral fluid testing in a safety sensitive industry and the correlation with diagnosed substance use disorders and possible impairment at work.

Methods: The trial involved 1,500 paired urine and oral fluid tests performed in accordance with Australian Standard/New Zealand Standard (AS/NZS) 4308:2008 and AS 4760:2006. Workers who returned a positive test were screened for substance use disorders, as defined by DSM-5, and for possible impairment at work following that particular episode of substance use.

Impact of rail medical standard on obstructive sleep apnoea prevalence.

Background: The 2004 edition of the National Standard for Health Assessment of Rail Safety Workers (the standard) used the Epworth Sleepiness Scale (ESS) to screen for excessive daytime sleepiness related to obstructive sleep apnoea (OSA). The 2012 edition of the standard expanded the OSA screening matrix to include body mass index, comorbid hypertension and type 2 diabetes as triggers requiring a sleep study to be undertaken irrespective of the ESS.

Aims: To assess the impact of the new standard on the estimated prevalence of OSA in railway workers.

Color Vision and the Railways: Part 3. Comparison of FaLant, OPTEC 900, and Railway LED Lantern Tests.

Purpose: The Farnsworth Lantern (FaLant) and the OPTEC 900 are nominated in the Commission Internationale de l'Éclairage (CIE) Color Vision Standard 2. Neither test uses the railway signal color code of red, yellow, and green, and only the OPTEC 900 is commercially available. The Railway LED Lantern Test (RLLT) is based on railway signaling practices in New South Wales, Australia, and is nominated in the Australian railway medical standard.